Therapeutic modulation of growth-promoting activity in platelets from diabetics

Proliferation of vascular smooth muscle is thought to be involved in the major diabetic complication atherosclerosis. We have previously reported an increase of growth-promoting activity (GA) in platelets from insulin-dependent diabetics. In this study, GA was measured in the platelet extract (PE) from eight diabetic patients who had been treated by conventional insulin therapy. Vascular smooth muscle cells from rat aorta were cultured and used as an assay system for GA. Incorporation of [3H]thymidine into DNA of cultured cells was stimulated by diabetic PE significantly more (P less than .05) than by normal PE. Diabetic PE incubated with cells for 4 days increased cell numbers significantly more (P less than .05) than normal PE. These abnormalities were corrected by long-term intensive insulin treatments (continuous subcutaneous insulin infusion and Pen infuser). The decrease of platelet extract GA appeared to correlate with the amount of insulin administered before meals as short-acting boluses, whereas the level of basal or long-acting insulin appeared to correlate with an increase of PE GA. Thus, the growth-promoting potential of platelets can be normalized by intensive insulin therapy. The relationship of insulin levels to this activity needs further evaluation.     

Modulation by calcium of the inhibitor activity of naturally occurring urinary inhibitors

The possibility that hypercalciuria could cause calcium stone formation through a mechanism other than by increasing urinary saturation of stone-forming calcium salts was explored. The effect of increasing calcium concentration on the inhibitor activity against the spontaneous precipitation of calcium oxalate was examined in whole urine (in the presence of naturally occurring inhibitors) and in synthetic media (with added inhibitors). In 11 patients with calcium nephrolithiasis, the induced hypercalciuria from calcium supplementation (600 mg/day) caused a significant fall in the urinary inhibitory activity against calcium oxalate precipitation, as shown by a decline in the formation product ratio from 12.6 +/- 1.1 SEM to 9.6 +/- 1.4 (P less than 0.005). In order to more fully explore this observation, the effect of increasing calcium concentration on the inhibitory activities of citrate (2 mM), chondroitin sulfate (0.05 mg/liter) and a heterogeneous group of naturally-occurring urinary inhibitors (1.0 mg/liter) against calcium oxalate precipitation was examined in vitro in synthetic solutions. The inhibitory actions of both citrate and chondroitin sulfate were significantly attenuated by increasing calcium concentration from 0.25 mM to 6.0 mM (P less than 0.01). However, raising the calcium concentration in synthetic media containing a mixture of partially purified urinary inhibitors produced a significant rise in the urinary inhibitory activity of this macromolecular mixture (P less than 0.01). We conclude that hypercalciuria can attenuate the inhibitory activities of citrate and chondroitin sulfate against calcium oxalate precipitation while at the same time accentuating the inhibitory activity of naturally-occurring urinary inhibitors.(ABSTRACT TRUNCATED AT 250 WORDS)     

重楼含药血清对大鼠系膜细胞增殖及凋亡的影响

【摘要】 目的 探讨重楼治疗肾小球疾病的作用机制。 方法 以脂多糖诱导MC增殖。提取大鼠的含药血清作用于体外培养的大鼠系膜细胞(MC)，观察重楼对MC增殖、凋亡的影响。用活细胞计数（CCK-8）法检测细胞增殖。以Hoechst染色及流式细胞仪检测细胞凋亡。用RT-PCR检测bcl-2 mRNA水平。 结果 重楼含药血清可抑制MC异常增殖、诱导MC凋亡，呈剂量依赖性。重楼各剂量组MC凋亡率[低、中、高剂量组分别为（11.72±0.32）％、（19.76±0.35）％、（18.71±0.41）％]较脂多糖组[（4.68±0.25）%]均显著增高(P均< 0.01)，重楼中剂量组与低剂量组间差异有统计学意义(P < 0.01)。重楼各剂量组MC bcl-2 mRNA表达[低、中、高剂量组分别为（51.06±0.77）％、（44.06±0.66）%、（35.68±0.67）％]较脂多糖组[（59.62±1.12）％]显著减少(P < 0.01)。重楼呈剂量依赖性降低MC bcl-2 mRNA表达水平(P < 0.01)。 结论 重楼含药血清可抑制MC增生和诱导MC凋亡，其机制可能与抑制抗凋亡基因bcl-2 mRNA的表达有关。     

Soluble immune complexes stimulate production of interleukin-1 by cultured rat glomerular mesangial cells

Interleukin-1 (IL-1) is a pleiotropic factor, eliciting a broad set of immunologic and inflammatory events. We have previously shown that IL-1 is present in inflamed glomeruli. To evaluate factors that might regulate of IL-1 production, we tested the effects of substances accessible to mesangial cells (MC): immune complexes (IC) are known to modulate MC function. We have attempted to assess the ability of soluble IC derived from rat glomerular basement membrane to induce the production of IL-1. When isolated MC were incubated with the soluble IC, substantial amount of IL-1 could be detected in the supernatants as measured by the mouse thymocyte assay. To block the effect of prostaglandins on the IL-1 assay, we cultured the MC with the addition of indomethacin and assayed IL-1 activity in the culture supernatants. The use of indomethacin resulted in a further increase in IL-1 production. These biological activities were neutralized by a specific antibody to IL-1. In the present report, we show that IC represent important sources of stimulation of MC for the production of IL-1. We speculate that IC could augment local inflammatory responses in the kidney partly due to their capacity to induce the production of IL-1.     

Studies on the tumor-promoting activities of additives in biomaterials: inhibition of metabolic cooperation by additives such as pigments and phenolic antioxidants

The inhibitory activities on the intercellular gap-junctional communication were investigated using the V79 metabolic cooperation (MC) assay for the detection of tumor-promoting activities of additives such as pigments and phenolic antioxidants. Among six pigments, four chemicals showed inhibitory activities. The inhibitory potencies were ranked in the following order: sudan I > purple 201 > blue 204 > green 202. Sudan I and purple 201 showed stronger inhibitory activities than lithocholic acid, which is known to be a tumor promotor. However, quinizarine and red 225 did not inhibit at any concentration. Relating to eight phenolic antioxidants, four chemicals also showed inhibitory activities. Combining the present findings with previous ones, there are many factors that have tumor-promoting activities via inhibitory action on gap-junctional intercellular communication in biomaterials.     

Renal tubular epithelial antigen-containing immune complexes stimulate interleukin-1 production by cultured rat glomerular mesangial cells

The ability of immune complexes (IC) derived from rat renal tubular epithelial (RTE) antigen to trigger the production of interleukin-1 (IL-1) was investigated. When cultured rat mesangial cells (MC) were activated by the IC, substantial amounts of IL-1 could be detected in the culture supernatants as measured by the mouse thymocyte assay. To avoid the effect of prostaglandins on the IL-1 assay, we cultured the MC with addition of indomethacin and assayed IL-1 activity in the culture supernatants. This cyclooxygenase inhibitor augmented IC-induced IL-1 production. These biological activities were neutralized by a specific antibody to IL-1. These findings suggest that IC may participate in local inflammatory responses in the kidney partly due to their capacity to induce the synthesis of MC IL-1.     

Plasma lipolytic activity. Relationship to postheparin lipolytic activity and evidence for metabolic regulation

Lipolytic activity was measured in human plasma without prior administration of intravenous heparin. Eluted from heparin-Sepharose in a barbital buffer containing 6 mg/ml heparin, plasma lipolytic activities in 20 subjects were distributed between hepatic triglyceride lipase (HTGL, mean +/- SE 60.6 +/- 4.6%) and extrahepatic lipoprotein lipase (LPL, 39.4 +/- 4.6%). Confirmation of the identities of HTGL and LPL was provided by inhibitory antisera. Preheparin LPL activity was absent in plasma from a patient with type I hyperlipoproteinemia. Both preheparin HTGL and LPL activities correlated with the respective activities measured in plasma obtained 15 min after intravenous injection of heparin (rs = + .774 and + .685, respectively; n = 12). Evidence for the metabolic regulation of preheparin lipases was provided by measurement of significant increases in LPL and HTGL activities after oral glucose ingestion. Overall, preheparin plasma HTGL and LPL activities may reflect ongoing lipoprotein lipolytic activity in tissue beds, and because these measurements do not require the administration of intravenous heparin, they should prove useful for additional studies of short-term regulation of the lipases.     

Effect of hyperoxaluria on the inhibitory activity of a 45-kD urinary protein

Proteins are thought to play a major role in stone formation and structurally abnormal proteins have been reported to be present in the urine of stone formers. This study was aimed to determine whether hyperoxaluria modifies the kinetic properties of urinary inhibitory proteins. Hyperoxaluria was induced by feeding 1% ethylene glycol to rats. Oxalate, uric acid and calcium excretion were increased progressively during hyperoxaluria, while magnesium level was decreased. Urinary proteins were separated on a DEAE-cellulose column by eluting with stepwise increasing salt concentration in 0.05 M Tris-HCl buffer (pH 7.0). Each protein fraction was studied for its crystallization inhibitory potential by the spectrophotometric method. The protein eluted in 0.3 M NaCl containing buffer had the maximal nucleation as well as inhibitory activity. The protein had a molecular weight of 45 kD. In hyperoxaluria, the urinary excretion of this protein significantly increased. In the crystal growth assay, the control rat 45-kD protein inhibited nucleation by 75% and aggregation by 100%. In contrast, it is very interesting to note that the protein derived from 28th day hyperoxaluric urine, behaved as a promoter of nucleation (-113%, percentage inhibition) and weak inhibitor of aggregation (28%). A significantly high negative correlation (r = -0.97) between oxalate excretion and the inhibitory activity of the 45-kD protein was observed suggesting a modification of the protein by oxalate.     

Role of polyethylene particles in peri-prosthetic osteolysis: A review

There is convincing evidence that particles produced by the wear of joint prostheses are causal in the peri-prosthetic loss of bone, or osteolysis, which, if it progresses, leads to the phenomenon of aseptic loosening. It is important to fully understand the biology of this bone loss because it threatens prosthesis survival, and loosened implants can result in peri-prosthetic fracture, which is disastrous for the patient and presents a difficult surgical scenario. The focus of this review is the bioactivity of polyethylene (PE) particles, since there is evidence that these are major players in the development and progression of osteolysis around prostheses which use PE as the bearing surface. The review describes the biological consequences of interaction of PE particles with macrophages, osteoclasts and cells of the osteoblast lineage, including osteocytes. It explores the possible cellular mechanisms of action of PE and seeks to use the findings to date to propose potential non-surgical treatments for osteolysis. In particular, a non-surgical approach is likely to be applicable to implants containing newer, highly cross-linked PEs (HXLPEs), for which osteolysis seems to occur with much reduced PE wear compared with conventional PEs. The caveat here is that we know little as yet about the bioactivity of HXLPE particles and addressing this constitutes our next challenge.     

Parathyroid hormone is not an inhibitor of lipoprotein lipase activity

The reduced lipoprotein lipase (LPL) activities in uraemia arereflected by increased serum triglyceride concentrations andreduced HDL cholesterol concentrations. Both hyperparathyroidismand circulating inhibitor(s) of LPL have been associated withthe disturbances of lipid metabolism in uraemia. The aim ofthe present study was to investigate if parathyroid hormone(PTH) had an inhibitory effect on LPL activity. Plasma post-heparinLPL activities, plasma LPL inhibitory activities, serum PTH_intactand serum PTHc-terminal concentrations were analysed in 20 patientson haemodialysis and 20 healthy controls. The effects of purified,human PTH_intact and a carboxyterminal fragment of PTH (PTH_39-84)on LPL activities in post-heparin plasma from healthy individualsand on the enzyme activity of purified, bovine milk LPL, activatedwith apolipoprotein CII, were studied. Patients had significantlyhigher plasma LPL inhibitory activities than controls, but therewas no correlation between plasma LPL inhibitory activitiesand serum PTH concentrations. Neither PTH_intact nor PTH_39-84had a significant effect on LPL activities in vitro. Thus therewas no evidence of a direct inhibition of LPL activity by PTHunder the present in-vivo or in-vitro conditions.     

Physicochemical and biomechanical examination of surfaces of retrieved polyethylene heads from total hip prostheses with rotating polyethylene head system

In order to assess whether hydrodynamic lubrication occurs in total hip prostheses with a rotating polyethylene (PE) head system (R-THP), several physicochemical, morphological, and biomechanical tests were carried out. R-THPs have been used in more than 1000 patients since 1970, and 12 PE heads, retrieved from 10 patients after an average of 24 · 5 years since total hip arthroplasty (THA), were employed for the tests. The weight-bearing area of the PE surface was light yellow in color and considerably oxidized, but no wear scars were observed. In the non-weight-bearing area, in contrast, discoloration and oxidation were hard to detect. The weight-bearing surface of the PE head became smoother with time after THA, and the friction coefficient did not differ significantly from that of an unused PE head. The radial clearance between head and socket decreased at a temperature of 17°C, which is equivalent to the difference between room temperature and the temperature of the human body. Scanning electron microscopy showed a fine undulating pattern, which suggested that hydrodynamic lubrication could occur in the rotating PE head system. Received: October 19, 2000 / Accepted: June 5, 2001     

Cytokine response of human macrophage-like cells after contact with polyethylene and pure titanium particles.

The aim of this study was to establish a human macrophage cell culture system to examine the effect of polyethylene (PE) and titanium particles on cytokine release by macrophage-like cells (MLC) and to quantify this response with respect to the nature and concentration of particles. Human monocytic leukemia cells were differentiated under standard conditions with vitamin D3 and granulocyte macrophage-colony-stimulating factor. Cells were characterized by fluorescence-activated cell-sorter Scan of CD 14 expression analysis as well as a phagocytosis test exploiting fluorescence-labeled particles of bacteria] walls. To achieve a relevant contact between the floating PE particles (approximately 1 microm in size) and MLC, a rotation device was used (15 rotations/min) during incubation. The same was done with the titanium particles. Cell culture supernatants were then analyzed for interleukin (IL)-1beta, IL-8, and tumor necrosis factor (TNF)-alpha using the enzyme-linked immunosorbent assay technique in the absence or presence of particles. Rotation of incubated MLC alone did not influence the secretion of TNF-alpha, but it enhanced secretion of IL-1beta and IL-8 about 30-fold compared to background levels. Both PE and titanium particles significantly enhanced MLC cytokine release, the amount of which depended on the concentration of particles. Using 40 X 10(8) PE particles (0.7 x 10(8) titanium particles) and 10(6) MLC, the maximal release of IL-1beta was about 20-fold (7-fold titanium particles) higher than that of the rotating control sample. The stimulation of IL-8 release was 4-fold (3-fold titanium particles) and of TNF-alpha. 300-fold (170-fold titanium particles) compared to controls. MLC were viable (>90% cell survival) at concentrations less than 108 x 10(8) polyethylene particles per 10(6) MLC and 16 x 10(8) titanium particles per 10(6) MLC. Rotation per se as well as exposure to increasing concentrations of PE and titanium particles stimulates cytokine release (TNF-alpha, IL-1beta, IL-8) by macrophages in vitro. This in vitro model resembles the in vivo situation near arthroplasties, where implant particles make contact with inflammatory cells, such as macrophages. Cytokine release by macrophages may impair osteoblast function as well as stimulate bone resorption by osteoclasts and macrophages, thereby causing aseptic loosening of arthroplasties. Our in vitro model provides a reproducible human cell system that might shed light on the pathogenesis of particle disease and might serve as a reproducible in vitro test system for the biocompatibility of foreign materials.     

Highly cross-linked polyethylene still outperforms conventional polyethylene in THA: 10-year RSA results

Background and purpose — Cup wear in total hip arthroplasty (THA) can be affected by different manufacturing processes of the polyethylene (PE). We report the long-term wear pattern differences, as well as early creep behavior, between conventional PE and highly cross-linked PE (HXLPE) liners, as measured with radiostereometry (RSA) up to 10 years. We also compare migration and clinical outcome of 2 similar uncemented cups with different backside surface roughness.Patients and methods — We included 45 patients with primary osteoarthritis. 23 received a conventional liner and 22 an HXLPE liner in a similar uncemented cup, but with a slightly rougher surface. The patients were followed up with RSA and hip-specific outcome questionnaire (HOOS) at 3 months, 1, 2, 5, and 10 years.Results — During the first 3 months both liners showed expected deformation with mean proximal head penetration of 0.39 mm (conventional PE) and 0.21 mm (HXLPE). Between 3 months and 10 years there was a difference in annual wear with 0.12 mm/year for the conventional liner and 0.02 mm/year for the HXLPE liner. The cup with rougher surface had less initial migration but both types had stabilized after 3 months. The HOOS scores improved after surgery and remained high for both groups throughout the study period.Interpretation — Up to 10 years the HXLPE has consistent lower annual wear, possibly contributing to longer survival of the THA, compared with conventional PE. All patients reported good results regardless of liner type.

Osteolysis, attributed to polyethylene wear debris, is one of the main causes of aseptic loosening in THA (Jacobs et al. 2001). Since highly cross-linked polyethylene (HXLPE) was introduced, several studies have shown reduced wear compared with ultra-high-molecular-weight polyethylene (UHMWPE), hereafter called conventional PE (Kuzyk et al. 2011, van Loon et al. 2020). Conventional PE liners demonstrate a mean wear rate of around 0.1 mm/year, which has been considered as the generally accepted osteolysis threshold. However, according to Dumbleton et al. (2002), a wear rate threshold of 0.05 mm/year eliminates the risk of osteolysis. The wear for HXLPE is reported to be substantially lower, down to 0.002 mm/year (Thomas et al. 2011, Snir et al. 2014, Glyn-Jones et al. 2015). Its improved wear resistance is related to the different manufacturing process of the liners; by different amount of radiation, annealing, or remelting of the polyethylene; and even different sterilizing techniques. To date, there is no clear evidence for superiority regarding wear for any of the manufacturing processes. Even when fundamental wear improvements occur, clinical effects require many years before being obvious, thus strengthening the importance of conducting long-term clinical studies as well as involving different processing techniques and manufacturers. Although wear of conventional PE and HXLPE has previously been compared in several studies, indicating superiority of HXLPE, there are to our knowledge only 2 comparable long-term prospective RSA studies (Johanson et al. 2012, Glyn-Jones et al. 2015). These studies, however, evaluate not only products from other manufacturers but different cross-linking processes as well. Furthermore, it is still debatable when the initial deformation (creep phase) ends, and when the actual wear phase begins for the different types of polyethylene. RSA is a reliable, validated method of assessing wear (Stilling et al. 2012).The CSF cup with standard conventional PE liner (JRI Orthopaedics Ltd, London, UK) has been on the market since 1991 showing satisfactory results (Datir and Angus 2010, Raman et al. 2012). The CSF Plus cup (JRI Orthopaedics Ltd, London, UK) was introduced in 2006, as an evolution of the CSF cup, with a slightly rougher and improved surface in combination with a new HXLPE liner. We measured and compared the possible differences between the 2 generations of this manufacturer’s polyethylene liners in terms of creep, wear, cup migration, and clinical outcome up to 10 years. Our hypothesis was that HXLPE would result in less wear and that the rougher cup surface would yield better cup stability. Additionally, the patients were evaluated with the clinical Hip Disability and Osteoarthritis Outcome Score (HOOS) throughout the follow-up period.     

Differential effects of oxidised and non-oxidised polyethylene particles on human monocyte/macrophages in vitro

Sterilisation by gamma irradiation in the presence of air causes free radicals generated in polyethylene (PE) to react with oxygen, which could lead to loss of physical properties and reduction in fatigue strength. Tissue retrieved from failed total hip replacements often has large quantities of particulate PE and most particles associated with peri-implant osteolysis are oxidised. Consequently, an understanding of the cellular responses of oxidised PE particles may lead to clarification of the pathogenesis of osteolysis and aseptic loosening. We have used the agarose system to demonstrate the differential effects of oxidised and non-oxidised PE particles on the release of proinflammatory products such as interleukin-1beta (IL-1beta), IL-6, and tumour necrosis factor-alpha (TNF-alpha) from monocytes/macrophages (M/M). Oxidised PE particles were shown to stimulate human M/M to phagocytose and to release cytokines. Oxidation may alter the surface chemistry of the particles and enhance the response to specific membrane receptors on macrophages, such as scavenger-type receptors.     

Isolation and purification of erythropoiesis inhibitory activity from uremic sera

In vitro erythropoiesis inhibitory activity (EIA) was isolated and partially purified from sera obtained from a patient with chronic renal failure (CRF). EIA was purified from human sera by ammonium sulfate precipitation, column chromatography and PAGE electrophoresis, and the corresponding biological activity was assayed in erythroid colony (CFU-E) cultures. Ammonium sulfate precipitation revealed that the EIA resided in two high molecular weight fractions which yielded a single peak on G-200 Sephadex. PAGE electrophoresis demonstrated that the EIA fraction separated into 3 bands with a molecular weight range of 12,000-50,000 daltons. Antibody to EIA was prepared in rabbits, and Ouchterlony immunodiffusion assays employing the antibody material revealed that several CRF sera generated intense double precipitin bands when tested in the assay. In contrast, normal sera consistently yielded a weak precipitin band. These results suggest the presence of reduced amounts of EIA-like material in normal humans and elevated levels in CRF sera. The significance of EIA in the anemia of CRF is discussed.     

Renal cancer specific antitumor activities of a mouse monoclonal antibody K2.7 to human renal cell carcinoma]

We have prepared a mouse monoclonal antibody (mAb) K2.7 (IgG3) by immunizing mice with renal cancer cell (RCC) line OS-RC-2. In a serological analysis by protein A assay, 25 out of 31 RCC lines reacted with the mAb K2.7 but none of the 50 other cell lines from different organs except for 2 cell lines did. In immunohistological analysis by indirect immunoperoxidase assay, 66 out of 72 renal cancer tissues showed positive staining. Metastatic lesions of renal cancers also reacted similarly to the primary lesion. Some restricted normal tissues including tubules of normal kidney showed positive staining. Specific antitumor activities of mAb K2.7 against RCC lines were investigated in vitro by complement dependent cytotoxicity (CDC) and antibody dependent cell mediated cytotoxicity (ADCC) assays. In CDC assay, all of the 9 RCC lines were killed by mAb K2.7 and normal human serum, and killing activities of mAb K2.7 presumably depend on the number of antibody molecules bound to the cell surface. Sera from 9 patients with renal cancers including low and high stages showed the same killing activities to 3 RCC lines as normal human serum. In the ADCC assay, peripheral leukocytes (PBLs) from 4 healthy donors showed strong killing activities to RCC lines. Killing activity differed with the individual. PBLs from the same 9 patients as in the CDC assay showed significantly positive killing activity against 3 RCC lines. These findings suggest the usefulness of mAb K2.7 for the specific immunotherapy of renal cancer.     

联合激动Toll样受体的树突细胞诱导抗结肠癌免疫反应

目的 观察联合激动Toll样受体(TLR)能否使树突细胞(OC)达到更理想的成熟状态,并诱导出抗结肠癌免疫反应.方法 在体外培养DC过程中加入TLR3和TLR7/8配体,流式细胞仪检测Dc重要表型表达,酶联免疫吸附实验(ELISA)法检测白细胞介素(IL)-12分泌量,~3H-thymidine掺入法检测DC促淋巴细胞增殖能力,使用CEA转基因鼠和转染CEA的MC38小鼠结肠癌细胞株(MC38-CEA)构建动物模型,乳酸脱氢酶(LDH)释放法检测DC诱导细胞毒性T淋巴细胞(CTL)对MC38-CEA的体外杀伤作用.结果 联合激动TLR的DC与常规组比较,能高水平表达DC重要表型,分泌更多IL-12(P＜0.01),更有效刺激淋巴细胞增殖(P＜0.01),荷载抗原后诱导的效应细胞在效靶比为20:1和40:1时,对MC38-CEA的杀伤率为(31.9±3.3)%和(39.1±4.2)%,而其他各组无明显杀伤作用(P＜0.05).结论 联合激动TLR的DC具有更理想的成熟度,能诱导更有效的抗肠癌免疫反应,提示联合激动TLR可能是增强DC肿瘤疫苗疗效的有效途径.     

全髋关节假体聚乙烯磨损和界膜组织学特征的研究

目的通过对聚乙烯假体表面进行扫描电镜观察,分析假体磨损方式,并结合假体周围界膜的组织学表现探讨其中的规律。方法临床翻修手术中采集12个国产全髋聚乙烯假体,通过扫描电镜观察表面磨损情况。同时测算聚乙烯摩擦界面磨损总量,并采集相应患者的假体周围组织进行组织学切片染色和定量评分,将磨损程度与组织学表现进行相关分析。结果聚乙烯表面的磨损特征存在差异,骨水泥三体磨损颗粒存在时多表现为以折痕、台阶和压坑形成为特征的塑性磨损;金属三体磨损颗粒多表现为以犁沟、划痕形成为特征的切削磨损。假体磨损越严重,假体周围慢性异物炎性组织学反应越明显,二者之间存在相关性。结论三体磨损颗粒的存在使聚乙烯假体磨损更加严重,其表现形式各有特点。磨损颗粒在界膜内蓄积并可引起显著的组织学反应。